DESCRIPTION (Adapted from applicants' abstract) Candidate: Ravi I. Thadhani received his M.D. in 1991 from the University of Pennsylvania. He then completed his internal medicine residency and served as Chief Medical Resident at the Massachusetts General Hospital. In 1995 he entered the Harvard School of Public Health and will complete the Masters' Program in Clinical Effectiveness by June 1997. He is interested in an academic research career studying modifiable risk factors of hypertensive disorders of pregnancy. Sponsor and Environment: Meir J. Stampfer, M.D., D.PH. has trained numerous investigators in the field of cardiovascular and nutritional epidemiology, areas in which he has published extensively. He is co-investigator of the Nurses' Health Study I and Nurses' Health Study II, which are based at Channing Laboratory, Brigham and Women's Hospital and Harvard Medical School. Dr. Stampfer is quite familiar with the research methods proposed in this project, and as a Professor of Epidemiology at the Harvard School of Public Health, he will also oversee Dr. Thadhani's formal education. Research: The applicant plans to examine prospectively the association between pre- and early-pregnancy risk factors and the subsequent development of transient hypertension of pregnancy or preeclampsia in two large cohorts: Nurses' Health Study II and the North Dakota WIC program. The following dietary hypotheses will be tested: pre- and early-pregnancy high intake of omega-3 fatty acids, antioxidants, and calcium reduces the risk of developing hypertensive disorders of pregnancy. Two non-dietary hypotheses will be tested: elevated serum cholesterol prior to pregnancy increases the risk, and smoking, which has been associated with a reduced risk, may not be associated with a reduced risk after adjusting for potential confounders. Diet in both cohorts will be measured by validated semiquantitative food frequency questionnaires developed at the Channing Laboratory. All cases will be verified by review of medical records. We expect 650 incident cases in the Nurses' Health Study II cohort (from 1991-2001) and 800 incident cases in the North Dakota WIC cohort (from 1995-2002). Because both cohorts are part of ongoing efforts, performing this study will be very economical. Furthermore, approximately 16% of women in the North Dakota cohort are of Native-American background, thus allowing us to evaluate a relatively under-studied segment of the population. Known risk factors for hypertensive disorders of pregnancy are either difficult or impossible to alter. The goal will be to identify dietary and non-dietary risk factors that may be amenable to modification prior to or early in pregnancy. (End of Abstract)